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Expert Rev Vaccines. 2008 Oct;7(8):1225-37. doi: 10.1586/14760584.7.8.1225.

Smallpox vaccines for biodefense: need and feasibility.

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  • 1Department of Medicine, Brown University, Memorial Hospital of RI, 111 Brewster Street, Pawtucket, RI 02860, USA.


Smallpox, eradicated as a cause of natural disease through an intensive global effort in the later part of the 20th Century, has resurfaced as a possible agent of bioterrorism. For this reason, there is renewed interest in smallpox vaccines. Live vaccinia virus, an orthopoxvirus related to smallpox, has a long and successful clinical track record as an effective smallpox vaccine; however, its use is associated with uncommon yet serious adverse events. This has led to a surge of recent research into newer-generation smallpox vaccines with improved safety profiles and retained efficacy. This article will review the history of smallpox vaccines, assess the status of newer-generation vaccines and examine the overall risk-versus-benefit profile of smallpox vaccination.

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